Objective: The virtual cone beam computed tomography–derived 3-dimensional model was compared with the scanned conventional model used in the fabrication of a palatal obturator for a patient with a large palatal defect. Design: A digitally derived 3-dimensional maxillary model incorporating the palatal defect was generated from the patient’s existing cone beam computerized tomography data and compared with the scanned cast from the conventional impression for linear dimensions, area, and volume. The digitally derived cast was 3-dimensionally printed and the obturator fabricated using traditional techniques. Similarly, an obturator was fabricated from the conventional cast and the fit of both final obturator bulbs were compared in vivo. Results: The digitally derived model produced more accurate volumes and surface areas within the defect. The defect margins and peripheries were overestimated which was reflected clinically. Conclusion: The digitally derived model provided advantages in the fabrication of the palatal obturator; however, further clinical research is required to refine consistency.
This is a clinical case describing a hypertensive female patient with a drug-influenced gingival enlargement (DIGE) on the labial and lingual gingivae of the lower anterior dentition. DIGE is attributed to the prolonged use of medications in a susceptible individual. She had undergone non-surgical periodontal therapy prior to surgical intervention for the removal of gingival enlargement (GE) using diode laser therapy. A diode laser is a type of laser widely used in dentistry. This laser therapy is a less invasive technique for the removal of GE. After 6 months of follow-up, no recurrence of GE was observed, and regular supportive periodontal therapy was adopted to sustain the gingival health. The utilization of the diode laser showed excellent predictability and clinical outcomes.
Patient dissatisfaction with tooth discoloration as a result of tetracycline therapy is not uncommon. To address patients' aesthetic demands, conservative bleaching treatments were considered before more invasive, irreversible treatments such as dental veneers or crowns. Bleaching is a relatively non-invasive, safe, and cost-effective method of achieving a desirable result. However, due to many limiting variables, including the extended duration of active bleaching, tetracycline-stained teeth are one of the most challenging cases to obtain satisfactory bleaching outcomes. This clinical report presents two cases of management of tetracycline staining of the teeth with varying degrees of severity.
Head and neck cancer patients require oral assessment and management prior, during and after cancer treatment to minimise oral complications. Hence, this study aimed to evaluate sociodemographic data, oral health management, oral complications derived from cancer treatment, time frame in completing dental treatment and association between oral management and complications. Purposive record sampling of head and neck cancer patients who completed radiotherapy and/or chemotherapy at Hospital Universiti Sains Malaysia (HUSM) from 2011 to 2017 were reviewed. A checklist was used to record the data and analysed using descriptive statistics and Pearson Chi-square test. A number of 194 patient records were reviewed with majority were Malays (88.1%), males (61.3%) with the mean age of 57.18 years old. Only 21% of the patients had oral assessment prior to cancer treatment. About 84% of the referred patients were dentally fit within 1 month. Mucositis and fungal infections were the most prevalent complications. The relationship between oral assessment prior to cancer treatment and oral complications was not significant (p = 0.134). Despite the insignificant association due to several limitations, oral assessment and management prior, during and after cancer therapy are recognised as crucial for improving quality of life. A standard institutional operating procedure is recommended to improve patient care.
Potential excessive removal of tooth structure during retreatment, and canal preparation for a post will weaken the tooth substantially. An alternative to prefabricated or cast metal and fibre posts, is a soft and flexible fibre-reinforced composite post that can be used to aid a good adaptation and preserve the tooth structure. These two case reports highlight the use of fibre-reinforced composite posts in teeth with severe loss of tooth structure with wide flared and oval canals. CPD/Clinical Relevance: Case selection and proper treatment planning are important before considering and selecting any type of post placement.
Globally, non-syndromic tooth agenesis is commonly seen in clinical practice. However, its management is often complex and requires a multidisciplinary team approach for the maximal outcome. While various treatment options are possible, considerations for the treatment are not only based on the dentofacial conditions but also cultural and social background and personal preference of the patient. Thus, patientcentred care approach should always be practised for an optimal outcome. In the present case, a patient with established craniofacial growth presenting with bilateral agenesis of maxillary lateral incisors and over-retained deciduous maxillary left canine sought for aesthetic improvements. The patient did not prefer any orthodontic treatment citing a prolonged treatment duration and sub-optimal motivation as a hindrance. Thus, a prosthodontic only approach was taken by providing a conventional cantilever bridge and ceramic veneers to achieve the aims of treatment. This article discusses the possible limitation of such prosthodontic only solution in managing tooth agenesis.
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